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Rapid Hypercalciuria Induction With Bone Formation Marker Reduction During Immobilization in Children
Haruna Otakeyama-Kakimoto1, Yasuko Ogiwara2, Norikazu Ota3
1Division of Endocrinology and Metabolism, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan; Department of Pediatrics, Kagoshima University Medical and Dental Science, Kagoshima, Japan.
Summary
Pediatric immobilization causes increased urine calcium levels and decreased bone formation markers, unlike adults. Bone resorption markers remained unchanged in children during this period.
Area of Science:
- Pediatric Orthopedics
- Pediatric Endocrinology
- Pediatric Nephrology
Background:
- Immobilization in children can lead to significant physiological changes.
- Understanding bone and calcium metabolism during immobilization is crucial for pediatric patient care.
Purpose of the Study:
- To prospectively investigate hypercalciuria and bone metabolite marker alterations in pediatric patients undergoing immobilization.
- To compare pediatric responses to immobilization-induced metabolic changes with those observed in adults.
Main Methods:
- Prospective study of 13 pediatric patients (median age 7 years) with orthopedic diseases requiring immobilization >2 weeks.
- Collected blood and urine samples to measure urine calcium/creatinine (Ca/Cr) ratio and bone metabolite markers.
- Measurements were taken before and at 1-4 week intervals during and after immobilization.
Main Results:
- Urine Ca/Cr ratio significantly increased within a week of immobilization (P < .01), returning to normal ~6 weeks after mobility.
- Serum alkaline phosphatase (ALP) and bone-specific ALP significantly decreased during immobilization (P < .01), returning to baseline in 2-4 weeks post-immobilization.
- Serum N-terminal telopeptides showed no significant change during immobilization.
Conclusions:
- Pediatric immobilization rapidly increases urinary calcium excretion (hypercalciuria).
- Bone formation markers (ALP) decrease in children during immobilization, contrasting with adults where resorption markers may increase.
- This study provides novel insights into pediatric bone metabolism during immobilization.
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